Individual
ADAM STARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA LCMHC LADC
Contact information
Practice address
122 BIRGE ST 2ND FL., BRATTLEBORO, VT 05301
(802) 254-9719
(802) 254-9719
Mailing address
39-8 BROOKSIDE DR, BRATTLEBORO, VT 05301
(802) 254-9719
(802) 254-9719
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
068-0000681
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1012381
—
VT
05
—
30424122
—
NH
Enumeration date
07/03/2006
Last updated
12/13/2010
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